Individual
DR. CHARLES RANDALL POWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
535 BARNHILL DR., INDIANAPOLIS, IN 46202
(317) 274-4622
(317) 274-0174
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01066313A
IN
208800000X
Urology Physician
125044893
IL
208800000X
Urology Physician
37723
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200950830
—
IN
Enumeration date
05/17/2007
Last updated
03/04/2025
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